Kobe (Dean and Lesley) MO
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Ketones were 0.3 yesterday and are up to 2.1 today. I'm starting to freak out.
I'm on hold with the Vet.
I'm on hold with the Vet.
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"Kobe" Continuation to Introduction Post DKA
- Thread starter Kobe (Dean and Lesley) MO
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Here's the link to your previous post. Thanks for starting the new one.
How is Kobe's appetite today? Activity level? What insulin dose did you give last night? It's not on the spreadsheet.
How is Kobe's appetite today? Activity level? What insulin dose did you give last night? It's not on the spreadsheet.
CORKY
Very Active Member
Good job on your new Post title, Hoping everything will be ok with Kobe, keep us posted!!
Kobe (Dean and Lesley) MO
Active Member
I attempted another 1.75, but with the markings on those bison syringes, it's impossible to say. I got some 5/10 cc syringes today from the Vet in town. Hopefully that helps my accuracy with tonight's dose.
Vet said to give him 100 mL of the sub q fluids. I warmed up the bag in a bowl of water in the sink and hung it on a hanger from the cat tree. We didn't get the full 100 before he became less interested in the treats and more interested in being done. We got most of it. I would say close to 75 mL.
I just tested BG and Ketones. BG was 275 and Ketones were back down to 0.3. The vet tech I talked to said that if I touched the blood end of the ketone strip, I could have got a bad reading. Maybe his ketones were not 2.1 earlier today. Maybe they were 0.3 this whole time. I either did a pretty good job averting a bad situation, or I am the biggest baffoon and touched the ketone strip.
The fluids aren't going the hurt him if he didn't need them, right?
Vet said to give him 100 mL of the sub q fluids. I warmed up the bag in a bowl of water in the sink and hung it on a hanger from the cat tree. We didn't get the full 100 before he became less interested in the treats and more interested in being done. We got most of it. I would say close to 75 mL.
I just tested BG and Ketones. BG was 275 and Ketones were back down to 0.3. The vet tech I talked to said that if I touched the blood end of the ketone strip, I could have got a bad reading. Maybe his ketones were not 2.1 earlier today. Maybe they were 0.3 this whole time. I either did a pretty good job averting a bad situation, or I am the biggest baffoon and touched the ketone strip.
The fluids aren't going the hurt him if he didn't need them, right?
Bron and Sheba (GA)
Very Active Member
Ketones can move around so it is possible they had gone up to 2.1 then down again. Either way… good job.
I think the 75 ml subQ fluids is plenty and it should not hurt him as long as the vet has given you the ok and has checked his heart.
Are you getting the 3/10 insulin syringes? They are much better to measure small doses
I think the 75 ml subQ fluids is plenty and it should not hurt him as long as the vet has given you the ok and has checked his heart.
Are you getting the 3/10 insulin syringes? They are much better to measure small doses
Kobe (Dean and Lesley) MO
Active Member
the 3/10 cc syringes are in the mail and due to arrive on Thursday. In the meantime, I got the 5/10 cc syringes from the other vet. They aren't ideal, but they are better than the 1 cc.
Kobe had permission from the Vet.
Kobe had permission from the Vet.
Kobe (Dean and Lesley) MO
Active Member
Just measured Ketones at 0.2!!!
BG is responding to the 1.75 units, but not as much as we had hoped. wondering if the dose needs to go up a little.
In the hospital, Kobe got "2" units, but I am wondering if he got a REALLY BIG 2 units. When the doctor measured his BG at +9, it was 66 on a non-human meter. So, just under the 68 which is still normal range, right? when I put it in Kobe's spreadsheet, I called it 49 because Kobe's SS is based on a human meter, so the 49 turned the cell the bright green color that indicates he was a little too low, lower than what we wanted but not by much.
Maybe the dose needs to go up a little once the 3/10 cc syringes with .5 unit marks come. I'd like to see his BG lower, but if the Ketones are trace only, I think we can wait until Thursday or Friday.
I found these guidelines on the Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing Sticky.
BG is responding to the 1.75 units, but not as much as we had hoped. wondering if the dose needs to go up a little.
In the hospital, Kobe got "2" units, but I am wondering if he got a REALLY BIG 2 units. When the doctor measured his BG at +9, it was 66 on a non-human meter. So, just under the 68 which is still normal range, right? when I put it in Kobe's spreadsheet, I called it 49 because Kobe's SS is based on a human meter, so the 49 turned the cell the bright green color that indicates he was a little too low, lower than what we wanted but not by much.
Maybe the dose needs to go up a little once the 3/10 cc syringes with .5 unit marks come. I'd like to see his BG lower, but if the Ketones are trace only, I think we can wait until Thursday or Friday.
I found these guidelines on the Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing Sticky.
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CORKY
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Kobe (Dean and Lesley) MO
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Dean and I aren't seeing any signs of nausea in Kobe. I am wondering if we can stop the anti-nausea meds. Kobe tolerates the sticks like a champ, but the pills are another story. The Maropitant is particularly offensive because it's bitter and makes him drool and smack his lips for about 5 minutes. If he needs the Maropitant, the drooling and smacking are a small price to pay, but if not... I hate to bother him more than I need to.
CORKY
Very Active Member
One way to give maropitant is to get some plain empty gel caps, size 3 or 4 might work for that med, and give the maropitant pill in that. If he's not vomiting and eating his meals well, you can try stopping the maropitant and seeing if he stays eating. Is he eating 1.5 times his normal calories now?
As far as insulin dose goes, it takes 5-7 days or 10-14 cycles for the depot to build when you first start Lantus. Today is cycle 4 at this dose. As long as his ketones stay low, you are OK with this dose.
When you say he got 2 units at the vet, that was the Lantus? Some cats will show an initial strong reaction to insulin which then fades away. But I wonder if there were other factors like him not eating enough at the vet.
As far as insulin dose goes, it takes 5-7 days or 10-14 cycles for the depot to build when you first start Lantus. Today is cycle 4 at this dose. As long as his ketones stay low, you are OK with this dose.
When you say he got 2 units at the vet, that was the Lantus? Some cats will show an initial strong reaction to insulin which then fades away. But I wonder if there were other factors like him not eating enough at the vet.
Kobe (Dean and Lesley) MO
Active Member
Oh, wow, okay. So yeah, as long as Ketones stay down, we'll keep the 1.75 for those 10 - 14 cycles. That's perfect, actually, because that puts us on a weekend where I can be home all day and wake up as much as needed overnight to monitor him if we decide to make a little increase. We'll just be patient.
He's eating more than he was. I am not sure if it's exactly 1.5 times as much, but it's probably close.
I think we'll skip the Maropitant tomorrow, and I'll get the empty capsules like you suggested. That way, if we need to administer it again we'll have them on hand. That's such a great idea. Thank you.
He's eating more than he was. I am not sure if it's exactly 1.5 times as much, but it's probably close.
I think we'll skip the Maropitant tomorrow, and I'll get the empty capsules like you suggested. That way, if we need to administer it again we'll have them on hand. That's such a great idea. Thank you.
Kobe (Dean and Lesley) MO
Active Member
Yes, 2 units of Lantus at the Vet. Sorry, I didn't answer your question.
Entirely possible he wasn't eating enough. The doctors say "oh, he ate for us," because he did, but they don't make sure it adds up to enough. They have so much going on.
CORKY
Very Active Member
Or they might not be too knowledgeable on FD , sometime vets are not familiar, Vets should have every minimal detail about Kobe on file everything, and you have the right to see it, and they treat it as it was a dog with diabetes, do not feel intimidated , ask your vet questions after questions, that’s why the more you read the main forum post and sticky notes you can make comparisons, and questions any discrepancies , I am sure with your Vets and the assistance of this forum Kobe will return to be himself very soon!! Dosing and the he food you feed are to me the most important thing in regulating a cats diabetes, honestly, I dont Think about it twice with advise on dosing for Corky, I or I should say we are both blessed he has no other ailments, since he left the hospital January 8, 2023 he has not stepped paw in a Vets office, I depend and blindly trust this forum and members, he would be alive if not, financially I cannot afford a vet visit, I even get assistance for insulin and supplies from DCIN Foundation, so I speak from the heart, it will get better much better as you become more knowledgeable in his treatments and never be afraid to ask when in doubt, Kobe know the love you have for himYes, 2 units of Lantus at the Vet. Sorry, I didn't answer your question.
Kobe (Dean and Lesley) MO
Active Member
Kobe is a pretty picky eater. We finally got him eating substantial amounts of wet food, but not enough to meet his caloric requirements. So he also eats Low Carb Power Cat Chicken and Turkey Kibble to make up the difference. We are trying to do as much wet food as possible, but now that we are trying to get 1.5 times as many calories, he's eating more kibble than I'd like.
I was starting some taste tests with him for the wet food I bought for the hypo kit. Doesn't do a lot of good to have a kit full of food that he won't touch, right? I wanted to make sure he would EAT it, so we could count on it in an emergency. Someone on here recommended the FF grilled options with gravy, about 12% carbs if memory serves. So we tried a tablespoon of the chicken one today. BIG HIT. Picky eater loved it.
My question is, can we mix the 3% carb FF Classic Pate, which he likes, but not quite enough, with the 12% carb FF Grilled with Gravy to make a 7.5% carb hybrid that is still under 10% carbs? Has anyone done this? I am just wondering if a little gravy boost could help get him to eat more wet food compared to kibble and still get the 1.5 x calories to help keep the Ketones away.
His appetite has been good, but he's been on the appetite stimulant and I have been home monitoring, putting little bowls of food under his nose to keep him eating extra. I have to go back to work tomorrow and won't be here to do that.
Ketones are holding at 0.2. Whew.
I was starting some taste tests with him for the wet food I bought for the hypo kit. Doesn't do a lot of good to have a kit full of food that he won't touch, right? I wanted to make sure he would EAT it, so we could count on it in an emergency. Someone on here recommended the FF grilled options with gravy, about 12% carbs if memory serves. So we tried a tablespoon of the chicken one today. BIG HIT. Picky eater loved it.
My question is, can we mix the 3% carb FF Classic Pate, which he likes, but not quite enough, with the 12% carb FF Grilled with Gravy to make a 7.5% carb hybrid that is still under 10% carbs? Has anyone done this? I am just wondering if a little gravy boost could help get him to eat more wet food compared to kibble and still get the 1.5 x calories to help keep the Ketones away.
His appetite has been good, but he's been on the appetite stimulant and I have been home monitoring, putting little bowls of food under his nose to keep him eating extra. I have to go back to work tomorrow and won't be here to do that.
Ketones are holding at 0.2. Whew.
CORKY
Very Active Member
Carbs are carbs and he will consume the whole 12% , 0-10 FF pates are the best also FF has a few flavors like Fish and Shrimp Flake is full of chunks of fish 0% carbs also Trout 4% , as a matter of fact, if you look at Corky’s SS scroll to the right on Remarks, you can see what both of my cats eat, mostly chunky foods 0-4% also Fancy Feast has from the Medleys Florentine flavors 10%
Here's the food chart again go to the Fancy Feast foods, the third column has the %'s of carbs, you can see the Medley Florentines, my cats especially Corky loves them, I use that one when his BG is in the 60's70, and I give only 1 tsp mixed with his regular food. the lower the carbs the better to regulate the Bg numbers to the low blues and greens, that's when the pancreas begin to heal!!
FOOD CHART CHECK CARBS/ FF
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We've had lots of people combine foods to either boost or lower the carbs. We are looking at %carbs from calories. If the calories from the two foods are roughly the same, then half of each should be close to the average carbs of the two.
Other things that help are crumbled freeze dried meat - we have called freeze dried chicken crumbles as kitty crack! Or a swirl of Churo on top. You could even pulverize a little bit of the dry food and season the wet food with that.
Other things that help are crumbled freeze dried meat - we have called freeze dried chicken crumbles as kitty crack! Or a swirl of Churo on top. You could even pulverize a little bit of the dry food and season the wet food with that.
CORKY
Very Active Member
Bron and Sheba (GA)
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Actually, many people find their cats do better with carbs around the 4% than feeding zero carbs.the lower the carbs the better to regulate the Bg numbers to the low blues and greens, that's when the pancreas begin to heal!!
CORKY
Very Active Member
100% Fact at least for Corky!!Actually, many people find their cats do better with carbs around the 4% than feeding zero carbs.
Kobe (Dean and Lesley) MO
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CORKY
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Kobe (Dean and Lesley) MO
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Good morning! We measured Kobe's ketones at 0.1 yesterday; happy see them continue to come down! He's eating without anti-nausea meds and without appetite stimulant. We had some nice BG numbers yesterday, but today I think Kobe is bouncing. I am thinking we just stay at 1.75 units for a while longer. Does this sound right?
CORKY
Very Active Member
CORKY
Very Active Member
I personallly cannot advice you on the insulin on you are using I am tagging several member that can or dosing matters I am sure someone will answer you shortly
@Bron and Sheba (GA)
Bron and Sheba (GA)
Very Active Member
Great to hear ketones are 0.1
Yes Coby is bouncing from those lovely blues yesterday. Now that you have seen some blue BGs with this dose, you will need to stay at this dose for at least 10 cycles. unless he drops under 90 in which case you would reduce the dose. If the ketones were to increase, we might have to look at the dose again but hopefully that wont happen. Keep testing for ketones.
Kobe (Dean and Lesley) MO
Active Member
Good evening! Kobe's ketones aren't high, but they are on the rise at the moment. Yesterday ketones were 0.1, today they are at 0.7. I know that typically ketones don't increase quickly, but they can. Can we get ahead of this with some fluids at home?
We are still a couple cycles away from knowing whether we should increase insulin or not. I will get up tonight to get some mid cycle numbers.
We are still a couple cycles away from knowing whether we should increase insulin or not. I will get up tonight to get some mid cycle numbers.
CORKY
Very Active Member
Bron and Sheba (GA)
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Yes you could give some subQ fluids. Have you only given them the once before? I would not give more than 70 mls. Keep the site you give the fluids away from where you give the insulin injections
Kobe (Dean and Lesley) MO
Active Member
Ketones are back down! Thank you!!!
CORKY
Very Active Member
Awesome!!!
You got this!!! Now looking forward to better days
SS looking much better
Kobe (Dean and Lesley) MO
Active Member
Good afternoon! Ten cycles after Kobe had those dark blue BG numbers, we raised Kobe's Lantus dose a hair, from 1.75 to 1.9 units, to help get rid of the Ketones. Since the switch to 1.9 units, Kobe's BG is floating around 300. I haven't measured it under 227. We are wondering if he needs another small increase in his dose. He's been at 1.9 units for 12 cycles. We'd appreciate your input!
Edit: Well, he just made a liar out of me. Tonight's PMPS BG was 215. Do we stay at 1.9 and wait to see if his BG comes down from the Bounce and the fir shot(s)? I still think BG has been a little high. I'd like to see it start coming down SLOWLY.
Edit: Well, he just made a liar out of me. Tonight's PMPS BG was 215. Do we stay at 1.9 and wait to see if his BG comes down from the Bounce and the fir shot(s)? I still think BG has been a little high. I'd like to see it start coming down SLOWLY.
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CORKY
Very Active Member
Kobe (Dean and Lesley) MO
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Hey, everybody. Kobe's BG is spending A LOT of time between 300 and 350.
We tried an increase from 1.9 to 2.1 units. His BG started going down pretty quickly and we kept it from going low with a little FF Gravy Lovers.
Then we tried an smaller increase from 1.9 to 2.0 units. BG still went pretty low to 64.
So he's back to 1.9 units again, but he's just spending most of his day between 300 and 350. Is this just where he needs to stay for now? Do we just need to be patient?
@Suzanne & Darcy
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
We tried an increase from 1.9 to 2.1 units. His BG started going down pretty quickly and we kept it from going low with a little FF Gravy Lovers.
Then we tried an smaller increase from 1.9 to 2.0 units. BG still went pretty low to 64.
So he's back to 1.9 units again, but he's just spending most of his day between 300 and 350. Is this just where he needs to stay for now? Do we just need to be patient?
@Suzanne & Darcy
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
CORKY
Very Active Member
I am not familiar with Lantus, or give you advice on dosing however those very high number can easily be on account of the high gravy carb food, the procedure when low like 64 you would start by testing first which you did, then give 1-2 medium carb food tsp test in half hour if still low repeat, the high carb , Karo or Honey which is a quick fix is when the BG is at point of HYPO, you give too much high carb, you will get higher numbers within 1/2-1 hour after, you want to stabilize first also If I am correct you do not raise or lower dose according to BG NUMBERS, , again I am not as knowledgeable as Lantus members. , and yes! patience is a virtue!!
Kobe (Dean and Lesley) MO
Active Member
I am not familiar with Lantus, or give you advice on dosing however those very high number can easily be on account of the high gravy carb food, the procedure when low like 64 you would start by testing first which you did, then give 1-2 medium carb food tsp test in half hour if still low repeat, the high carb , Karo or Honey which is a quick fix is when the BG is at point of HYPO, you give too much high carb, you will get higher numbers within 1/2-1 hour after, you want to stabilize first also If I am correct you do not raise or lower dose according to BG NUMBERS, , again I am not as knowledgeable as Lantus members. , and yes! patience is a virtue!!
We are just feeding FF Classic Pate with no gravy mixed in. Kobe's brother had an allergic reaction to the gravy, so we stopped mixing. It was worth a shot.
We didn't intervene with any gravy when the numbers were in the 60s. He had those numbers around when we would have expected a nadir, so we just made sure he ate and kept testing.
We had to use the gravy when his AMPS was 157. On that day, I gave a reduced, but not insignificant, dose because of the low AMPS. (Previously, for lower than normal PS we had given a token dose which led to very high BG for days. We had also tried giving dose as normal, which resulted in a pretty big bounce). I checked BG 2 hours later right before I was supposed to leave for work. BG was STILL going down when it was supposed to have stayed about the same. Encouraged food, but BG was STILL going down and the new shot hadn't even kicked in yet. That is when we got out the gravy. His BG was trying to go low (for him) for almost FIVE HOURS. We tried regular food first, like the protocol says, but regular food wasn't slowing the decline.
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Bron and Sheba (GA)
Very Active Member
You are jumping around a bit with the dosing and not really following SLGS method. I would try staying with the 1.9 (not sure why it is 1.9 and not 2 units …are you using calliper ?) and seeing how that goes.
Try getting a +2 test after the shots and see if the BG is dropping. If you feed then, you might be able to stop a faster drop.
Try getting a +2 test after the shots and see if the BG is dropping. If you feed then, you might be able to stop a faster drop.
Kobe (Dean and Lesley) MO
Active Member
Thanks for taking the time to respond.
I know the 1.9 is a little ridiculous, but when the Vet did 2 units it was too much. When we tried 2 units again, it was still too much. It seems like 1.9 might be his number for now.
I will try to get some +2 data.
We'll stay at the 1.9 like you said and be patient. I guess I was just hoping to see more yellow on the spreadsheet and I am just worried that staying between 300 and 350 most of the day is hurting him.
We didn't mean to jump around. When the dose increase didn't go the way we hoped, we just had a lot of unpredictability, like low pre-shot numbers, and not wanting to eat at meal time (shot time). We eager to get back on track!
I know the 1.9 is a little ridiculous, but when the Vet did 2 units it was too much. When we tried 2 units again, it was still too much. It seems like 1.9 might be his number for now.
I will try to get some +2 data.
We'll stay at the 1.9 like you said and be patient. I guess I was just hoping to see more yellow on the spreadsheet and I am just worried that staying between 300 and 350 most of the day is hurting him.
We didn't mean to jump around. When the dose increase didn't go the way we hoped, we just had a lot of unpredictability, like low pre-shot numbers, and not wanting to eat at meal time (shot time). We eager to get back on track!
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Bron and Sheba (GA)
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Kobe could be bouncing from the green BGs a couple of days ago. Let’s see how the next couple of days goes.
Keep posting
Keep posting
Kobe (Dean and Lesley) MO
Active Member
Kobe had a very low (for him) AMPS (79) and we ended up skipping his dose. We are back to 1.75 units. Was the decrease the right thing to do? We are worried about the ketones coming back with a smaller insulin dose.
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CORKY
Very Active Member
Bron and Sheba (GA)
Very Active Member
If you are doing SLGS it is ok to reduce the dose. Can you put what dosing method you are following in the signature please.
Are you still checking for ketones. That is the best way to monitor them.
How’s his appetite. Remember lots of food.
Are you still checking for ketones. That is the best way to monitor them.
How’s his appetite. Remember lots of food.
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